Does this pulse oximetry report look like sleep apnoea?

Hi everyone,

I'm new here, so sorry if this is a stupid question.

My girlfriend is tired all the time, to the point that she will fall asleep within seconds any time she feels comfortable during the day. She had an appointment at a sleep clinic, and they think she might have obstructive sleep apnoea (OSA) caused by her unusually large tonsils. They said they would send her a pulse oximeter in the post so that they can diagnose her, but this won't happen until the end of the month, so I got impatient and bought a CMS-50E (as many people on here seem to recommend).

We recorded her pulse oximetry readings last night (see below for an image of the report), but I'm not sure whether they're indicative of OSA. She only had 5 SpO2 events, so it seems as though her airway isn't being blocked long enough for her SpO2 levels to drop. However, her number of pulse events seems very high (around 15 an hour).

Her snoring tends to get progressively worse until she disturbs herself, then she rolls over. I think what's happening is that her airway gets blocked briefly, but she rolls over before it causes an SpO2 event. Could this be what's causing the high number of pulse events?

We plan to record her sleep a few more times then go back to the doctor with the results, but I just wondered if you guys had any thoughts on this. Thanks in advance for any input

If she's sleeping on her back at all, I'd make every effort not to - it can be the difference between 'having' at least what's called positional apnea and not having any, or enough to qualify. The desats did not seem to be a problem.

seem like hypnoapneas. It migh be worth looking inyo UARS. arousal from breathing problems.

Yeah, she seems to be worse on her back. I bought her a Rematee bumper belt to try and keep her on her side, but she still managed to sleep on her back and woke up complaining that it hurt

She does snore on her side sometimes though.

concerned_boyfriend wrote:Yeah, she seems to be worse on her back. I bought her a Rematee bumper belt to try and keep her on her side, but she still managed to sleep on her back and woke up complaining that it hurt

She does snore on her side sometimes though.

My advice. Let her sleep next to recording device in a quiet room. Repeat it a couple of nights. look out she snores and has gasps or breath stops. if she has typical OSA of the severe or moderate grade you'll notice. You can use audacity to get an analysis of the snoring frequency and any change in breathing patterns. But I'll put this with a disclaimer. It's not a substitute for a polysomnography or a homestudy. Just a crude way of getting an idea of the snoring pattern and whether there are any typical breath obstructions. You can always watch her sleep for an hour or two. See if there any noticable obstructions.

As an FYI, many people diagnosed with sleep apnea do not have O2 desaturations. As a result, your girlfriend definitely needs a sleep study in light of having apnea symptoms and large tonsils.

49er

49er wrote:As an FYI, many people diagnosed with sleep apnea do not have O2 desaturations. She definitely needs a sleep study in light of having apnea symptoms and large tonsils.

49er

Aren't Oxygen desaturations a part of the clinical defnition of OSA.Thats what i remember from reading. If there are no oxygen desats then its either a insensitibe, malfunctioning oximeter or UARS. Full obstructions will cause desaturations below normal.

tiredandscared wrote:

49er wrote:As an FYI, many people diagnosed with sleep apnea do not have O2 desaturations. She definitely needs a sleep study in light of having apnea symptoms and large tonsils.

49er

Aren't Oxygen desaturations a part of the clinical defnition of OSA.Thats what i remember from reading. If there are no oxygen desats then its either a insensitibe, malfunctioning oximeter or UARS. Full obstructions will cause desaturations below normal.

OSA is not the only thing that can cause the desats...She needs a sleep study to be sure.

tiredandscared wrote:

49er wrote:As an FYI, many people diagnosed with sleep apnea do not have O2 desaturations. She definitely needs a sleep study in light of having apnea symptoms and large tonsils.

49er

Aren't Oxygen desaturations a part of the clinical defnition of OSA.Thats what i remember from reading. If there are no oxygen desats then its either a insensitibe, malfunctioning oximeter or UARS. Full obstructions will cause desaturations below normal.

Quoting from sleepstar, a sleep tech, who posted in your thread about your home test:

For an event to be a hypopnea, it must have an oxygen desaturation of 3% (or 4% depending on the laboratory) OR an arousal (3 seconds of an increase in brain activity) OR both of these.

I tried to look up the official sleep study scoring rules but my search skills are not working today unfortunately. But do recall reading exactly what she mentioned somewhere.

Not sure how apneas are scored but hopefully, you see where I am coming from.

49er

LSAT wrote:

tiredandscared wrote:

49er wrote:As an FYI, many people diagnosed with sleep apnea do not have O2 desaturations. She definitely needs a sleep study in light of having apnea symptoms and large tonsils.

49er

Aren't Oxygen desaturations a part of the clinical defnition of OSA.Thats what i remember from reading. If there are no oxygen desats then its either a insensitibe, malfunctioning oximeter or UARS. Full obstructions will cause desaturations below normal.

OSA is not the only thing that can cause the desats...She needs a sleep study to be sure.

Great point LSAT.

Thanks for the input everyone

The sleep clinic said that they would do a proper sleep study if the pulse oximeter results were inconclusive (which they seem to be, from this discussion), so we can go back and push for that.

Just to be clear: the number of pulse events is abnormally high, right?

concerned_boyfriend wrote:Thanks for the input everyone

The sleep clinic said that they would do a proper sleep study if the pulse oximeter results were inconclusive (which they seem to be, from this discussion), so we can go back and push for that.

Just to be clear: the number of pulse events is abnormally high, right?

Go to the sleep clinic and ask if you can borrow a proper pulse oximeter. These low end oximeters by contec aren't super precise. They can even give false positives just by having the perfusion low or the finger getting misaligned.

tiredandscared wrote:Aren't Oxygen desaturations a part of the clinical defnition of OSA.

no.

tiredandscared wrote:Go to the sleep clinic and ask if you can borrow a proper pulse oximeter. These low end oximeters by contec aren't super precise.

this is unnecessary. the contec devices are plenty accurate enough.

what she needs is a home sleep test, not an oximeter. oximeters cannot rule out sleep disordered breathing.

Too bad we can't have a device which measures stress hormone levels, continuously.